Homozygous TREM2 c.549del; p.(Leu184Serfs*5) variant causing Nasu-Hakola disease in three siblings in a consanguineous Iraqi family: Case report and review of literature

Mol Genet Genomic Med. 2024 Jun;12(6):e2476. doi: 10.1002/mgg3.2476.

Abstract

Background: The Triggering Receptor Expressed on Myeloid Cells 2 protein (TREM2) plays a crucial role in various biological processes, including osteoclast differentiation, and disease-associated microglia (DAM) activation to regulate neuroinflammation, and phagocytosis in the brain. Genetic variations in TREM2 are implicated in neurodegenerative disorders, such as Nasu-hakola disease (NHD), characterized by bone lesions, neuropsychiatric disorders, and early-onset dementia.

Methods: We studied 3 siblings with suspected NHD. Whole-exome sequencing was conducted on the proband to identify the possible genetic cause(s) and by Sanger sequencing to validate the identified variants in the two other affected siblings, a healthy sister, and the parents.

Results: We identified a novel homozygous deletion (c.549del; p.(Leu184Serfs*5)) in TREM2. Our literature review reveals 16 TREM2 mutations causing early-onset dementia and bone lesions.

Conclusion: These findings, alongside previous research, elucidate the clinical spectrum of TREM2-related diseases, aiding accurate diagnosis and patient care. This knowledge is vital for understanding TREM2-dependent DAM and its involvement in the pathogenesis of neurodevelopmental disorders which can help to develop targeted therapies and improve outcomes for TREM2-affected individuals.

Keywords: Nasu‐Hakola disease (NHD); TREM2; disease‐associated microglia (DAM); genetic variations; neurodegenerative disorders; whole‐exome sequencing (WES).

Publication types

  • Case Reports
  • Review

MeSH terms

  • Consanguinity
  • Female
  • Homozygote*
  • Humans
  • Lipodystrophy* / genetics
  • Lipodystrophy* / pathology
  • Membrane Glycoproteins* / genetics
  • Osteochondrodysplasias* / genetics
  • Osteochondrodysplasias* / pathology
  • Pedigree
  • Receptors, Immunologic* / genetics
  • Siblings*
  • Subacute Sclerosing Panencephalitis* / genetics
  • Subacute Sclerosing Panencephalitis* / pathology

Substances

  • Membrane Glycoproteins
  • Receptors, Immunologic
  • TREM2 protein, human

Supplementary concepts

  • Polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy